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Neurona
Published by Perhimpunan Dokter Spesialis Neurologi Indonesia
ISSN : 02166402     EISSN : 25023748     DOI : https://doi.org/10.52386/neurona
Core Subject : Health, Science,
Health Professions Medicine & Pharmacology Neuroscience
Neurona merupakan satu-satunya jurnal yang memuat perkembangan penelitian dan kasus terbaru bidang neurosains oleh Perhimpunan Dokter Spesialis Saraf (PERDOSSI) Pusat di Indonesia. Jurnal ini diterbitkan bulan Maret, Juni, September dan Desember. Bidang studi cakupan NEURONA meliputi: Stroke dan Pembuluh darah Neurotrauma Neuroonkologi Neuro Infeksi Neuro Behavior Neurorestorasi Neuropediatri Gangguan Tidur Nyeri Kepala Neurootologi Neuro Intervensi Neuro Intensif Neurogeriatri Gangguan Gerak Epilepsi Neuro Epidemiologi
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 299 Documents
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MIGRAIN RETINAL Devi Ariani Sudibyo; Isti Suharjanti; Imas Resa Palupi
NEURONA Vol 38 No 4 (2021)
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Abstract

Retinal migraine can affect serious complications in patients through persistent visual disturbances. It has been described as repeated monocular visual disturbances, including scintillations, scotoma, or blindness, accompanied by migraine headaches. Few journals and case reports discuss retinal migraine. We report a 23-year-old female presented with recurrent left headaches, which were preceded by visual disturbances in the form of scotoma, blurred vision and dark vision. Visual disturbances occurred in the left eye, lasting 5 to 15 minutes before headache. According to the 3rd edition of the International Classification of Headache Disorder (ICHD-3), the patient met the diagnostic criteria for retinal migraine. Flunarizine 10mg as a retinal migraine prophylactic medication gave good results. Keywords: flunarizine, headache, migraine, retinal, visual aura.
SINDROM PIRAMIDAL BILATERAL MENYERUPAI KLINIS SINDROM GUILLAIN-BARRE Putri Auliya; Ahmad Yanuar Safri; Taufik Mesiano; Winnugroho Wiratman; Fitri Octaviana; Manfaluthy Hakim
NEURONA Vol 38 No 4 (2021)
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Abstract

A 35-year-old man came with weakness in all four limbs with ascending paralysis. The patient experienced a weakness in the right leg initially, followed by the left leg within three hours and involved both arms within one day. The patient was taken to the emergency room afterwards, and within four days, the patient developed tetraplegia, experienced weaknesses of the vocal cord and must be assisted by the ventilator. Lumbar puncture and plasmapheresis were performed, but no improvement was seen. Subsequently, the patient underwent magnetic resonance imaging (MRI) and obtained a picture of subacute infarction on bilateral medulla oblongata pyramidal seen in ????heart shape????. Patients were rehabilitated and given secondary stroke preventive therapy. Clinical findings in this patient were very similar to the clinical findings in Guillain-Barre Syndrome as this cause delayed diagnosis and therapy of the stroke. Both of these two syndromes can be life-threatening because respiratory failure can occur. Keywords: Bilateral pyramidal syndrome, GBS, Guillain-barre syndrome, stroke
FAKTOR-FAKTOR YANG MEMPENGARUHI KUALITAS HIDUP PENDERITA PENYAKIT PARKINSON DENGAN MENGGUNAKAN PARKINSON’S DISEASE QUESTIONNAIRE-39 Oktavianus Tambun; Selly Marisdina; Erial Bahar
NEURONA Vol 38 No 4 (2021)
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Abstract

Introduction: Parkinson’s disease is the second most common neurodegenerative disorder with motor and nonmotor symptoms. The manifestations of Parkinson’s disease evolve in morbidity and quality of life (QOL) reduction. QOL is an essential measurement for Parkinson’s disease, one of the instruments has been used in Parkinson’s Disease Questionnaire-39 (PDQ-39). Aim: To recognize factors affecting QOL of patients with Parkinson’s using PDQ-39. Methods: This study was an observational analytic study, cross-sectional design, carried out on Parkinson’s patients, conducted at Mohammad Hoesin, Pusri and Bhayangkara Hospital from 1 June to 30 September 2020. Data was collected using the PDQ-39 questionnaire, Non-Motor Symptoms Questionnaire (NMSQ), Mini-Mental State Examination (MMSE). Moreover, this study also assessed the degree of disease severity with the Hoehn and Yahr Scale. Results: There were 52 subjects with a mean of age 65.13±10.28 years, and the majority were over 60 years (69.2%), male (55.????%), and had stage III disease severity (59.6%), with disease duration ≥5 years (63.5%). There were 59.6% patients with good QOL and 40.4% with poor QOL. We found that the disease’s stage (p=0.009), duration (p=0.006), and sensory symptoms (p=0.014) had a significant effect on the patient's QOL based on bivariate analysis. Furthermore, multivariate logistic regression analysis showed that the disease’s stage (p=0.029; OR=3.186) and sensory symptoms (p=0.070; OR=3.771) had the most significant effect on the Parkinson's QOL. Discussion: The factors affecting the QOL of patients with Parkinson’s were the disease’s stage, duration, and sensory symptoms. Key words: Parkinson’s disease, PDQ-39, quality of life
PENGARUH KADAR BRAIN DERIVED NEUROTROPHIC FACTOR PADA HENDAYA KOGNITIF RINGAN TIPE AMNESTIK Yuda Turana; Yvonne S Handayani
NEURONA Vol 38 No 4 (2021)
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Abstract

Introduction: Several clinical studies have shown the relationship between brain-derived neurotrophic factor (BDNF) and amnestic type mild cognitive impairment (aMCI). A significant reduction in peripheral BDNF levels due to aging is a predisposing factor for clinical manifestations of dementia in the elderly. Aim: To determine the role of BDNF and the risk factors for aMCI. Methods: Cross-sectional study, comparative analytic in the elderly group with normal cognitive function and elderly with aMCI. The study used secondary data from the Atma Jaya Cognitive and Aging Research Project in the elderly group ≥ 60. There were 109 data on the elderly who met the criteria, and the elderly were divided into MCI, aMCI, nonamnestic, and normal cognitive function. Results: It was found that 46.7% of the subjects had aMCI. Most of the subjects were women (70.6%) with a mean age of 64.04±5.54 years, less than six years of formal education (40.4%), and over body weight (49.5%), systolic hypertension (4????.1%), and LDL levels ≥130 mg/dL (61.1%), and had a mean BDNF level of 3010 pg/mL. In the sub-analysis, female subjects with aMCI had a significantly lower mean BDNF than normal cognitive subjects (p=0.029). Discussion: There was no effect on BDNF levels, demographic characteristics, lipid profile, body mass index and blood pressure with the incidence of aMCI. In the female subpopulation, low levels of BDNF were associated with the incidence of aMCI Keywords: BDNF, elderly, mild cognitive impairment
FAKTOR-FAKTOR YANG MEMPENGARUHI KEJADIAN NYERI PUNGGUNG BAWAH PADA TENAGA MEDIS DI SILOAM HOSPITALS LIPPO VILLAGE KARAWACI Evlyne Erlyana Suryawijaya; Yusak Mangara Tua Siahaan; Ika Paula Fransiska Purba; Vinson Hartoyo
NEURONA Vol 38 No 4 (2021)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v38i4.267

Abstract

Introductions: Low back pain (LBP) has been known as one of the most common complaints by healthcare workers (HCWs). LBP in healthcare workers, particularly in Indonesia, is often associated with tentative working schedules, relatively high workload and mechanical factors such as manual handling of the patient. Aim: To investigate the prevalence and factors contributing to LBP in HCWs. Methods: This was an analytic observational study using a cross-sectional method. We gathered primary data using a questionnaire from HCWs in Siloam Hospitals Lippo Village Karawaci, Tangerang, from a period of October to December 2017. Results: A total of 171 subjects were enrolled in this study. We found that the prevalence of LBP in HCWs was 63,7%. Significant factors found to be associated with LBP were occupation as nurse (p=0,007), activity of pulling (p=0,002), lifting (p=0,024), pushing (p= 0,003), and forward bending (p= 0,012). Discussion: LBP in HCWs might be caused by the combination of repetitive trauma and activities which interact with heavyweight and abnormal posture. Keywords: healthcare workers, low back pain.
SINDROM NYERI KANKER: PATOFISIOLOGI DAN KLASIFIKASI KLINIS Yusak Mangara Tua Siahaan
NEURONA Vol 38 No 4 (2021)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v38i4.268

Abstract

Cancer pain is a subjective and complex complaint that is a priority in the world of oncology because it affects most aspects of the patient’s life, especially on quality of life and psychosocial responses. The recognition of cancer pain syndromes and the ability to analyze differences in the underlying pathophysiology and etiology as clinical classification are important because they determine the therapeutic and prognostic implications needed by cancer pain syndrome sufferers. Pathophysiologically, cancer pain is divided into nociceptive pain, neuropathic pain or mixed pain. Keywords: cancer pain, clinical classification, pathophysiology
FAKTOR-FAKTOR YANG MEMENGARUHI LUARAN THERAPEUTIC PLASMA EXCHANGE PADA KRISIS MIASTENIA DI RSUPN CIPTO MANGUNKUSUMO Manfaluthy Hakim; Triana Ayuningtyas; Ahmad Yanuar; Nadia Ayu Mulansari; Winnugroho Wiratman; Luh Ari Indrawati; Astri Budikayanti; Fitri Octaviana
NEURONA Vol 38 No 4 (2021)
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Abstract

Introduction: Myasthenic crisis (MC) occurs due to worsening symptoms of myasthenia gravis (MG) characterized by acute respiratory failure, prolonged post-thymectomy intubation or bulbar weakness causing dyspnoea. Therapeutic Plasma Exchange (TPE) has been accepted as first-line therapy for MC. The management of TPE is not quite ideal according to the American Society of Apheresis (ASFA) recommendations. Aim: To determine the factors that in????uenced the outcomes of MC patients who underwent TPE Methods: This study was a cross-sectional design by taking secondary data on MC cases that received TPE at RSUPN Cipto Mangunkusumo from January 2014 to September 2018. The diagnosis of MC is based on clinical examination. Bivariate analysis was carried out on factors that infuenced TPE outcomes in MC. Results: A total of 38 cases met the inclusion criteria. Good outcomes after undergoing TPE are found in 60.5% of cases. The onset of MG (p=0.039) and type of MG (p= 0.001) have a significant relationship with TPE outcome on MC. Early-onset MG and ocular to generalized MG show good outcomes. Antibody specificity variables showed a strong trend in infuencing TPE outcome in MC (p=0.055). Patients with MC who underwent TPE according to ASFA showed faster clinical improvement than those who underwent TPE not according to ASFA. Discussion: Early-onset MG and ocular to generalized MG are factors that can affect the excellent outcome of TPE in MC. Patients who undergo TPE, according to ASFA, show faster clinical improvement. Keywords: ASFA, myasthenic crisis, therapeutic plasma exchange
PERAN PARAMETER HEMOREOLOGI DAN HEMOSTASIS SEBAGAI FAKTOR PROGNOSIS STROKE ISKEMIK AKUT DENGAN COVID-19 Al Rasyid
NEURONA Vol 38 No 4 (2021)
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Abstract

Heretofore Coronavirus Disease-2019 (COVID-19) is still a serious global health threat. COVID-19 manifests not only in the respiratory system but also in the nervous system, one of which is acute ischemic stroke. There may be a reciprocal association between COVID-19 and acute ischemic stroke. Infection that occurs in COVID-19 offers detrimental effects on blood viscosity and the coagulation system. Disturbance of blood viscosity and coagulation system would cause deceleration of blood ????ow and thromboembolic, hence predisposing ischemic stroke. Disturbance of both parameters is also associated with worsening outcomes in ischemic stroke and COVID-19, as evaluated by the modified Rankin scale (mRS), Barthel index (BI) and mortality rate. Keywords: Acute ischemic stroke, blood viscosity, coagulopathy, COVID-19
MANAJEMEN SUBDURAL HEMATOMA KRONIS: SEBUAH PARADIGMA BARU STRATEGI NEUROINTERVENSI Fritz S. Usman; Graha Agung Mulyono; Beny Rilianto; Hendra Irawan; Nasrul Irawan; Gunawan Septa Dinata; Erwin Joe
NEURONA Vol 38 No 4 (2021)
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Abstract

Chronic Subdural Hematoma (cSDH) is a significant challenge in neurology; it causes high morbidity and mortality rates and a high risk of recurrence. The primary mechanism of cSDH is the microhemorrhage caused by the repeated cycle of inflammation and angiogenesis. Treatment options for cSDH vary from conservative management, surgical therapy, endovascular strategy, or any combination. The endovascular strategy for cSDH management is embolizing the middle meningeal artery. This strategy gives neurologists a promising treatment option, as it proposes a minimally invasive option or, in conjunction with surgery, can prevent recurrences. In addition, middle meningeal artery embolization can also be done in a frail, elderly patient who will not tolerate an extensive craniotomy procedure; the procedure provide earlier ambulatory, which minimalizes hospital cost. Keywords: Chronic Subdural Hematoma, endovascular strategy, middle meningeal artery embolization
HUBUNGAN TINGKAT KETERGANTUNGAN DAN TINGKAT STRES PASIEN STROKE AKUT RAWAT INAP Daniella Natasya; Budi Riyanto Wreksoatmodjo; Mahaputra Mahaputra
NEURONA Vol 38 No 4 (2021)
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Abstract

Introduction: Stroke is the second leading cause of death worldwide and the leading cause of disability in adults. Disability will affect functional abilities in activities of daily living which can lead to mental health issues, for example, psychological stress. Aim: This study aims to determine the relationship between the level of dependence and the level of stress in hospitalized acute stroke patients Methods: A cross-sectional analytic study was conducted on 64 respondents of acute stroke patients hospitalized at Atma Jaya Hospital and Izza Hospital from November 2020-March 2021. The level of ADL dependence was determinedusing the Barthel Index questionnaire, and the stress level was determined using the DASS-42 questionnaire. Data analysis using Chi-square test with alternative Kruskal Wallis test. Results: Most respondents were male (59.4%) and aged ≥ 59 years (62.5%). The majority have a moderate level of dependence (42.2%) and experience moderate stress (39.1%). There is a relationship between the level of dependence and the stress level with a p<0.05. Discussion: Limitations in daily activities caused by a stroke can cause stress. Untreated, prolonged stress can lead to more serious mental health disorders. Families and nurses need to carry out psychological management to improve the quality of life of stroke survivors. Keywords: Acute stroke, ADL, dependency level, stress level

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